Organization Name: | COUNTRYHOUSE RESIDENCES |
NPI Number: | 1093116998 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHANIE MYRBERG (DIRECTOR) |
Mailing Address: | 5030 S 155th St Omaha |
State: | NE US |
Postal Code: | 681375002 |
Phone Number: | 4029642060 |
Fax Number: | |
NPI Enumeration Date: | 09/10/2014 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311500000X |
License Number: | 2988 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Alzheimer Center (Dementia Center) |
Taxonomy Specialization: | |
Taxonomy Definition: | A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer |